Laserfiche WebLink
Environmental Health Department <br />2. <br />Address: <br />Phone: <br />3. <br />74. <br />5. <br /> Other (specify): <br />6.Api <br />9. <br />meats, tamales, cooked beans, rice. <br />7. <br />8. <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products. <br />Note: The only operations not required to provide enclosed booths <br />approved dispensers, or prepackaged foods from approved sources. <br />prayed water for drinking, utensil and hand washing will be provided in my booth by the foltowing methods: <br />Approved bottled water. <br />SAN JOAQUIN <br />COUN-v <br />the festival coordinator three (3) weeks prior to this event. <br />1. <br />are those which sell beverages from <br />0 A booth with walls and celling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete, <br />areas from t^ 30(1 Srn00th W00d are accePteb,e) and constructed to separate food and food preparation <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | vmw.sjgov.org/eiKi <br />EHD 16-02 Page 7 of 11 TEMP EVENT APP <br />07/01/2024 <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): /___ ___________________________ <br />Electricity is provided for my booth's use: Yes 0 No <br />I am providing an accurate probe thermometer to measure the hot and cold holding of potentially hazardous <br />foods during all times of booth operation: 0res No <br />I am providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />EZlZamp stove Stemo & hotel trays <br />0 Double steamer Steam table & lids <br /> Electric stove top Other (specify) <br />H Yes No <br />Phone: (.___) <br />I.Name of EventHumtain Muse QfM <br />The following is information about my organization/business: <br />Name of organization/business: jL j>y(e Q a P wry <br />-Ui3__Cf} <br />(Kv), 1 u - Alternate: ( ) <br />List food to be sold or given to the public: (/h <br />I prepared at home: 0Yes No <br />is from approved commercial facilities: <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />,0 8 -nd completed copy of this checklist to <br />Date(s); <br />I am providing food thaH <br />All food is preparedon-si <br />Name of facility: <br />Address of facility: <br />' aH' a wi,h the followin9: <to protect m* unpackaged food and food-preparation areas from flies, <br />dusrand the public)